What causes spondyloarthropathies?

Experts don't
know what causes spondyloarthropathies. The presence of a particular
gene, HLA-B27, is often associated with ankylosing
spondylitis. Spondyloarthropathies, especially ankylosing spondylitis, are more likely to run in families than
other forms of rheumatic disease, such as
lupus or rheumatoid arthritis.

What are the symptoms?

Spondyloarthropathies often
cause:

Low back pain that may spread into the
buttock.

Morning stiffness, especially in the back or neck, that gets better during the day and
after exercise.

Fatigue.

Although spondyloarthropathies all result in joint pain,
each type also has specific symptoms.

Ankylosing spondylitis causes stiffness and
low back pain. Over time, the pain usually moves from the lower back into the
upper back. In severe cases, the affected joints in the
spinefuse together, causing severe back stiffness.
Other areas (such as the hips, chest wall, and heels) may also be affected. In
children, symptoms usually begin in the hips, knees, heels, or big toes and
later progress to the spine.

Reiter's syndrome causes pain,
swelling, and
inflammation of the joints, especially in the
sacroiliac joint, the attachment between the lower back and pelvis, and in the
fingers, toes, and feet. The fingers and toes may swell, causing a "sausage
digit." Reiter's syndrome can also cause fever, weight loss, skin rash, and
inflammation. In children, the joints of the lower legs are most commonly
affected.

Psoriatic arthritis is a form of arthritis associated
with a skin condition called
psoriasis. The psoriasis symptoms (scaly red patches
on the skin) often precede the arthritis symptoms, sometimes by many years. The
severity of the rash does not mirror the severity of the arthritis. The
fingernails and toenails may show pitting or thickening and yellowing. The
joint problems involve large joints, such as the hips and sacroiliac joints.
Swelling of entire toes or fingers, resulting in sausage digits, also
occurs.

Enteropathic arthritis is spinal arthritis that also
involves inflammation of the intestinal wall. Symptoms can come and go. And
when the abdominal pain is flaring, this arthritis may also flare. The
arthritis typically affects large joints, such as the knees, hips, ankles, and
elbows. In children, the arthritis may begin before the intestinal
inflammation.

A general difference between spondyloarthropathies and
juvenile spondyloarthropathies is that in adults, the spine generally is
affected, while in children the arms and legs are more frequently affected.
Children may have 4 or fewer joints that are painful or swollen (typically the
knees or ankles), inflammation of a part of the eye (iritis), and
neck pain and stiffness.

Spondyloarthropathies may cause
inflammatory eye disease, particularly
uveitis. In some cases, spondyloarthropathies can
cause disabilities, particularly if bones in the spine fuse together. People
who have spondyloarthropathies for a long time may develop complications in
organs, such as the heart and lungs.

How are spondyloarthropathies diagnosed?

Spondyloarthropathies are diagnosed through a medical history, lab
tests, imaging tests such as an X-ray or MRI, and by symptoms of joint and tissue inflammation, morning stiffness, and
other symptoms unique to a specific spondyloarthropathy (such as scaly skin in
psoriatic arthritis). Different types of tests may be done for the different
spondyloarthropathies.

How are they treated?

In most
cases, spondyloarthropathies are mild and may be undiagnosed for many years.
Most people do not have trouble with daily activities. Treatment is focused
on relieving pain and stiffness and on good posture and stretching of the
affected areas to prevent stiffening and deformity.
Nonsteroidal anti-inflammatory drugs (NSAIDs) are
commonly used to treat pain and inflammation linked to
spondyloarthropathies. Other treatment options depend on the type of
spondyloarthropathy you have. For example, medicines are used to treat
intestinal inflammation in enteropathic arthritis.

Be safe with medicines. Read and follow all instructions on the label.

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